Henry, Gavin L
Henry, Gavin L is an individual health care provider with primary practice located at 22 S Greene St , Baltimore MD 21201. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery). Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) is his primary health care specialty. Henry, Gavin L can be contacted via phone (410) 328-6366.Contact Information
Primary practice address
22 S Greene St
Baltimore MD 21201
Phone: (410) 328-6366
Fax: (410) 328-0693
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | D0053308 | Maryland |
| Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | D0053308 | Maryland |
Profile Details
| NPI number | 1033179098 |
|---|---|
| LBN Legal business name | Henry, Gavin L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 24th, 2006 |
| Last updated | Jul 13th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033179098 | NPPES |
| Maryland | MEDICAID | 407680000 | |
| Maryland | Other | K51964580202 | |
| Maryland | Other | W6620199 |
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